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Glycemic variabilit...
Glycemic variability and hypoglycemia before and after Roux-en-Y Gastric Bypass and Sleeve Gastrectomy : A cohort study of females without diabetes
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- Nilsen, Inger, Cand. Scient, 1968- (author)
- Uppsala universitet,Institutionen för kostvetenskap,Centrum för klinisk forskning Dalarna,Department of Dietetics and Speech Therapy, Mora Hospital
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- Sundbom, Magnus (author)
- Uppsala universitet,Gastrointestinalkirurgi
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Osterberg, Johanna (author)
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- Laurenius, Anna (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
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- Andersson, Agneta, 1968- (author)
- Uppsala universitet,Institutionen för kostvetenskap
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- Hänni, Arvo (author)
- Uppsala universitet,Klinisk nutrition och metabolism,Department of Surgery, Bariatric Unit, Falun Hospital; Department of Diabetes/Endocrinology, Uppsala University Hospital
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- Elsevier, 2024
- 2024
- English.
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In: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 20:1, s. 10-16
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Abstract
Subject headings
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- BACKGROUND: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) lead to lower fasting glucose concentrations, but might cause higher glycemic variability (GV) and increased risk of hypoglycemia. However, it has been sparsely studied in patients without preoperative diabetes under normal living conditions.OBJECTIVES: To study 24-hour interstitial glucose (IG) concentrations, GV, the occurrence of hypoglycemia and dietary intake before and after laparoscopic RYGB and SG in females without diabetes.SETTING: Outpatient bariatric units at a community and a university hospital.METHODS: Continuous glucose monitoring and open-ended food recording over 4 days in 4 study periods: at baseline, during the preoperative low-energy diet (LED) regimen, and at 6 and 12 months postoperatively.RESULTS: Of 47 patients included at baseline, 83%, 81%, and 79% completed the remaining 3 study periods. The mean 24-hour IG concentration was similar during the preoperative LED regimen and after surgery and significantly lower compared to baseline in both surgical groups. GV was significantly increased 6 and 12 months after surgery compared to baseline. The self-reported carbohydrate intake was positively associated with GV after surgery. IG concentrations below 3.9 mmol/L were observed in 14/25 (56%) of RYGB- and 9/12 (75%) of SG-treated patients 12 months after surgery. About 70% of patients with low IG concentrations also reported hypoglycemic symptoms.CONCLUSIONS: The lower IG concentration in combination with the higher GV after surgery, might create a lower margin to hypoglycemia. This could help explain the increased occurrence of hypoglycemic episodes after RYGB and SG.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Näringslära (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nutrition and Dietetics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Keyword
- Carbohydrate intake
- Continuous glucose monitoring (CGM)
- Edinburgh hypoglycemia scale
- Glycemic variability
- Hypoglycemia
- Interstitial glucose concentration
- Low-energy diet
- Open-ended food record
- Roux-en-Y gastric bypass
- Sleeve gastrectomy
- centration
- Glycemic variability
- Carbohydrate intake
- Low -energy diet
- Open-ended food record
- Hypoglyce
Publication and Content Type
- ref (subject category)
- art (subject category)
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